Download An Introduction to Integrative East West Medicine

An Introduction to
Integrative East West Medicine
Malcolm Taw, MD
UCLA Center for East West Medicine
Department of Medicine
David Geffen School of Medicine, UCLA
Outline
Introduction to Integrative East West Medicine
An Overview of the UCLA Center for East West
Medicine
Clinical/Research Interests
Philosophy
Modern
Western Medicine
(MWM)
Reductionistic
Microscopic
Structure
Quantitative
Separation of
Mind-Body
Traditional
Chinese Medicine
(TCM)
Holistic
Macroscopic
Function
Qualitative
Preservation of
Mind-Body
Origin of Reductionism
Limbic Music – (Massachusetts General Hospital: Handbook
of General Hospital Psychiatry, 4th ed, p. 12)
“In reductionism what one reduces and gets rid of is,
in fact, mind …The culprit for this great, supposed split
between brain and mind is usually thought to be Descartes
… One often hears the phrase ‘Cartesian dualism’.”
George B. Murray, MD
Director of Psychosomatic Program
Harvard Medical School
Language
Western
Eastern
Alphabet
Several words
Phonetic
Complex grammar
Pictures
Few characters
Not phonetic
Minimal grammar
Evolution of Chinese Characters
Natural image
Mountain
Moon
Sun
Morning
Ancient depiction
Modern character
Integrative East West Medicine
(Inherent Barriers)
• Translation often is not one-to-one
• Lack of equivalent concepts in medicine
Ex: TCM has no nervous/endocrine system
Western medicine lacks concept of
dampness/wind
Integrative East West Medicine
(Common ground)
TCM
MWM
Man
Environment
Yin & Yang Theory
Two extremes brought into dynamic balance
Black/White, Hot/Cold, Day/Night
Yin & Yang Theory
(Modern Western Medicine)
Hot/Cold (Physiologic temperature = 98.6 deg F)
Acid/Base (Physiologic balance pH = 7.4)
Sympathetic/Parasympathetic
Electrolyte disorders
Oxygen/CO2
Hyper/Hypothyroidism
EDUCATION
CLINIC
UCLA CENTER FOR
EAST-WEST MEDICINE
RESEARCH
COMMUNITY OUTREACH
INTERNATIONAL
DEVELOPMENT
UCLA Center for East-West
Medicine
MISSION: To improve health, well-being, and quality of
life by incorporating the best of Western and traditional
Chinese medicine.
PROGRAMS OF THE CENTER:
-- Clinical
-- Educational
-- Research
-- International
- Affiliated UCLA Programs (centers, research
groups, and organizations actively involved in the
CCIM)
UCLA Brain Mapping Center
UCLA Brain Research Institute
UCLA Center for East-West Medicine
UCLA Center for Human Nutrition
UCLA CNS: Center for Neurovisceral Sciences &
Women's Health
UCLA/CURE/Brain Gut Research Group
UCLA Learning and Memory Project
UCLA Norman Cousins Center for
Psychoneuroimmunology
UCLA Opioid Research Center
UCLA Pediatric Pain Program
UCLA Pelvic Pain Clinic
Features of the Clinic
Clinic Staff
Over a dozen health care providers that include both
Western and Eastern trained physicians
Patient referral
Over 12,000 patient visits a year
Primarily referred from specialists in the UCLA system
Patient population
Most patients exhaust other conventional treatments
Patients who fail or are intolerant of medications/surgery
Predominantly non-Chinese
What disorders do we treat?
Chronic Pain Conditions
Neck/Low back/Pelvic
pain
Headaches
Myofascial pain
Chronic Pain Syndrome
Fibromyalgia
Degenerative arthritis
Post surgical chronic pain
Patient Symptoms
Gastrointestinal
complaints
Chronic fatigue
Anxiety/Depression
Sinusitis
Cancer related problems
Skin disorders
Women’s health related
problems
Integrative East-West Approach
Assess adequacy of any prior
conventional work up and treatment
Complete health history including
psychosocial, stress, sleep, nutritional,
and other lifestyle factors
Conventional physical exam
supplemented by palpation of
acupoints and TCM tongue diagnosis
TCM Approach to the Patient
Focus on enhancing the body’s
endogenous resistance (homeostatic
reserve) to disease
Restore normal balance and flow
Individualization of treatment
Less emphasis on specific causal
factors
Patient Evaluation
MWM
History/ Physical Exam
Disease
Treat disease
Pattern (Zheng)
Diagnosis
Treat symptom/
underlying cause
TCM
Chinese Medicine
Western Medicine
Therapeutic Modalities
Acupuncture
Trigger point
injections
Therapeutic
massage
Dietary and herbal
counseling
Mind-body exercises
Tai Chi
Patient education
Lifestyle
Nutrition
Acupressure/selfmassage
Complementary
& Alternative
Medicine (CAM)
mixing
Deleterious Effects
adverse interactions
fragmentation of care
waste of resources
cost-generating
iatrogenesis
Modern Western
Medicine
true integration
New Paradigm
safe
effective
affordable
accessible
Clinical/Research Interests
Use of Integrative East-West Medicine to Treat:
1) Hypertension
- Acupuncture/Acupressure
- Addressing the Mind/Body Connection
- Dietary/Lifestyle changes
- Tai Chi
2) Disorders of the Ears, Nose & Throat
- Sinusitis
- Allergic Rhinitis
- TMJ syndrome
- Eustachian Tube Dysfxn
- Dizziness/Vertigo
Clinical/Research Interests
3) Dermatologic Conditions
- Chronic Urticaria
- Refractory Pruritus
- Atopic Dermatitis/Eczema
4) Chinese Herbal Medicine
Clinical Pharmacolog
- Better understand herb-drug interactions
- Provide a safe & effective integrative therapeutic
model
- Compare/contrast MWM vs TCM pharmacologic
paradigms
Chronic Sinusitis Study
Malcolm Taw MD, Chau Nguyen MD, Marilene Wang MD, and Ka-Kit Hui MD
UCLA Center for East-West Medicine
UCLA Division of Otolaryngology
Prospective Pilot Study
Twenty patients with documented Chronic
Rhinosinusitis - screened by Otolaryngologist
at UCLA
Will enroll adults, 18-65 y.o. who are able to
give informed consent
Exclusion Criteria
Obvious surgical candidates (ie. nasal
polyposis, allergic fungal sinusitis)
Autoimmune disorders
HIV+, hepatitis
Previous sinus surgery within 3 mos
Prior acupuncture within 2 mos
Treatment Course
Weekly treatments x 8
Acupuncture, therapeutic acupressure/
massage, trigger point injections
TCM dietary/lifestyle counseling
Self acupressure
Endpoints
QOL surveys
SF-36
Chronic Sinusitis Survey, SNOT-20
Taken at baseline, 2 months, 6 months,
and 1 year